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Long-Term Outcomes of Transcatheter Aortic Valve Replacement
The Placement of Aortic Transcatheter Valves (PARTNER) trial demonstrated that transcatheter aortic valve replacement (TAVR) for high-risk patients with aortic stenosis resulted in similar outcomes at 1, 2 and 3 years compared with surgical aortic valve replacement (SAVR). The present study reports the 5-year outcomes of this trial. The study enrolled 699 patients who were randomized to SAVR or TAVR (via a transfemoral or transapical approach). Overall, mean age was 84.1 years, 94% were NYHA Class 3 or 4, and the mean Society of Thoracic Surgeons Predicted Risk of Mortality at 30 days was 11.8%. At 5 years, there were no significant differences in mortality between groups (67.8% in the TAVR group versus 62.4% in the SAVR group; hazard ratio 1.04, 95% CI 0.86–1.24; p=0.76). There were no significant differences in cardiovascular mortality, stroke, or need for repeat hospital admission. Patients receiving TAVR experienced more major vascular complications (11.9% vs 4.7%; p=0.0002) and fewer major bleeding events (26.6% vs 34.4%; p=0.003). Development of moderate or severe aortic regurgitation was more common following TAVR (14% vs 1%; p<0.0001) and was associated with higher mortality at 5 years (72.4% for moderate or severe aortic regurgitation compared with 56.6% for those with …
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